Today's Challenges

Dialysis for diabetes patients is not a cure.
Within five years, 50% of dialysis patients in
Indian Country die.

Diabetes

Native Americans have the highest rate of diabetes of any ethnic group in the U.S. — 2.8 times the overall rate of diabetes. As a result, Indians die of kidney disease earlier than the white population.

Diabetes contributes to heart disease, the leading cause of death in all ethnic groups. People with diabetes often go blind or have legs amputated. More and more young Indians are developing diabetes. And as LeAnne Howe says — speaking from personal experience with her grandmother — "Diabetes is the disease that steals your body blind, then takes what's left — your memory."

The cruel irony is that it's a preventable disease. Taking a walk is one of the simple lifestyle changes that can make a big difference.

"Getting fast food out of the schools, putting physical education back into schools, making policies so that there is a healthy, safe place to go take a walk. There is infrastructure that we all have the power to change," says Dr. James M. Galloway, director of the Native American Cardiology Program for the Indian Health Service.

The Eastern Band Cherokee are trying innovative approaches to diabetes education and lifestyle issues.

The Cherokee Choices program featured in Spiral of Fire is tackling the disease through screening and prevention programs. Screening is designed to get patients into treatment early when the hope for recovery is higher. Prevention involves convincing people at high risk to change their day-to-day diets and exercise habits.

The Cherokee program is especially concerned with reaching children, as are other Indian Health programs around the U.S. They're finding that it's not enough to take soft drinks out of schools or talk to kids about eating and exercising. In Native American communities, they start with instilling a sense of self-worth and pride in the culture.

Dr. Ann Bullock says they are trying "to go in and work with the kids, hopefully before some of the trauma has set in too deeply. To mirror back to these children how critically important their lives are, how beautiful they are which is not a message that traumatized people can always give to their children. In fact, they usually can't mirror back. We can't mirror back to a child what we don't have in ourselves."

It's hard. Research has shown that historic trauma can lead to a sense of fatalism within Native populations — the feeling that nothing you do will make any difference.

LeAnne's mother, dying of diabetes, told her, "I'm going to die anyway, might as well let me have a piece of chocolate."